The Harm Reduction debate: Political Expedience vs Progress

On June 24th, the Urban Health Research Institute released a report on 15 years of data on drug use in the city of Vancouver. The results of their analysis are significant, but predictable to those who work in the field – harm reduction has saved lives and led to a decrease in drug use, while the war on drugs had failed to do either.

Since the mid 1990’s, the number of people sharing needles has fallen dramatically while usage of needle exchange services and methadone treatment programs has increased. This means that far fewer people are getting HIV and Hep C from drug use and fewer are dying of overdoses because of services like Insite. Such would not have been possible without key champions and advocates from across the spectrum including health, municipal, and police officials, and of course organizations of people who use drugs including VANDU.

An equally apparent takeaway from this report is that the “war on drugs” in Vancouver has completely failed to meet any of its objectives. Data from the same 15 years shows that despite the millions spent on drug enforcement and interdiction, drug availability and pricing has remained unaffected and stable.

The findings in this report also illuminate the many misperceptions about harm reduction services that we often see in the media. One such misperception is that harm reduction services are somehow the opposite of abstinence-based drug treatment. In fact, when people access harm reduction services, including unused drug use supply distribution and methadone, they are often taking the first step towards abstinence and recovery.

The Conservative Party of Canada is capitalizing on these misperceptions to support and promote the introduction of Bill C-65, the Respect for Communities Act. This legislation, if passed, will make it more difficult to set up life-saving supervised injection services in other parts of the country and is part of a sustained attack on harm reduction programs by the government’s National Anti-Drug Strategy.

We know from talking with people from across the country, that many Canadians are concerned about this hostility to well-established harm reduction services, which are supported by organizations such as the United Nations Office on Drugs and Crime, UNAIDS, and the World Health Organization.

It’s time to take a deeper look at the myths about harm reduction and expose them for what they are – politically expedient and uninformed dismissals of well-researched and successful health care services. It comes down to a rather obvious choice: Do we want people to use drugs openly in our streets or in other unsafe and unhygienic conditions, or do want to provide services that have shown to engage people in life-saving health care and drug treatment? It’s as simple as that and the Urban Health Research Institute’s report underscores this point with a wealth of data.

Harm reduction services are based on a pragmatic, non-judgmental approach to the provision of health services that respects the dignity of people who use drugs and values their human rights. Because these services have minimal requirements for involvement, they are often the first points of entry to other health and social services.

Harm reduction is not the only approach to problematic substance use but it is a major means of preventing the transmission of disease, overdose and death, connecting people to services and opening a pathway to change. These services have key secondary benefits such as increased access to health services, housing referrals, referrals to drug treatment, counseling, education, and testing for HIV and HCV.

So next time you hear politicians saying they favour drug treatment over harm reduction consider the possibility that these services are part of the same continuum and ask them why they keep repeating these myths despite the existence of so much evidence to the contrary.

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